Progress in treatment with personality-disordered clients can be subtle, non-linear, and easily
overlooked, especially when it doesn’t look like traditional symptom reduction. This session focuses on how to recognize signs of emotional and relational growth that often emerge
beneath the surface or in small but meaningful ways.

Clients may not verbalize their progress, and at times may appear to regress or destabilize as
deeper emotional work begins. However, subtle shifts, like pausing before reacting,
expressing vulnerability, or questioning long-held beliefs, can indicate profound internal
movement. Learning to spot these moments is essential for maintaining therapeutic
momentum and preventing clinician discouragement or premature treatment changes.

We’ll explore what growth looks like across different stages of therapy, including increased
tolerance for discomfort, improved reflective functioning, willingness to repair ruptures, and
more regulated interpersonal interactions. We’ll also address how to avoid reinforcing
dependency, over-pathologizing ambivalence, or missing the client’s unique markers of
change.

Through case vignettes and discussion, clinicians will gain tools to affirm and reinforce
progress without rushing the process or imposing their own timeline. The session will also
cover how to help clients internalize their gains and develop a growing sense of agency and
self-efficacy.

Ultimately, recognizing and celebrating progress, however small, builds hope, strengthens
the therapeutic alliance, and supports the long-term integration of healthier ways of thinking,
feeling, and relating. This session provides a practical and compassionate framework for
tracking change and helping clients feel seen in their growth.

What You’ll Learn:

1. Detect Subtle Signs of Progress:
   Identify and interpret nuanced indicators of emotional and relational growth in clients with personality disorders, such as increased self- reflection, pauses before reacting, or greater willingness to express vulnerability.
2. Support and Reinforce Therapeutic Change:
   Develop strategies to affirm and reinforce small but meaningful shifts in client behavior and emotional regulation, fostering hope and sustaining therapeutic momentum without imposing external timelines.
3. Differentiate True Progress from Regression or Ambivalence:
   Learn to distinguish between genuine growth, temporary destabilization, and ambivalence, avoiding the reinforcement of dependency or over- pathologizing normal fluctuations in the therapeutic process.
4. Facilitate Client Internalization of Gains:
   Apply techniques to help clients recognize, own, and internalize their progress, cultivating agency, self-efficacy, and long-term integration of healthier ways of thinking, feeling, and relating.

Agenda:

Lecture & Chat-Based Q&A; Learn to detect and support signs of emotional and relational progress.

10 min – Defining Progress in PD Treatment
Emphasize process over outcomes

15 min – Case: Subtle Shifts Over Time

Highlight changes in insight, emotional regulation, or boundaries

30 min – Small Group Reflection

What does progress look like in your client? How has it evolved?

20 min – Strategies to Support Growth

Reinforcement, collaborative goal setting, validating effort

15 min – Documentation and Communication
How to describe and chart progress for clinical teams or supervision